| National Provider Identifier [NPI]: | 1316054125 |
| Last Name Of The Provider | AVEDISIAN |
| First Name Of The Provider | RALPH |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | DO |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 7 N ATKINSON DR |
| Street Address 2 Of The Provider | SUITE 111 |
| City Of The Provider | LUDINGTON |
| Zip Code Of The Provider | 494311953 |
| State Code Of The Provider | MI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 88 |
| Number Of Services | 6379 |
| Number Of Medicare Beneficiaries | 1413 |
| Total Submitted Charge Amount | 434598 |
| Total Medicare Allowed Amount | 290332.81 |
| Total Medicare Payment Amount | 203868.12 |
| Total Medicare Standardized Payment Amount | 214214.32 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 7 |
| Number Of Drug Services | 83 |
| Number Of Medicare Beneficiaries With Drug Services | 48 |
| Total Drug Submitted ChargeAmount | 5221 |
| Total Drug Medicare AllowedAmount | 2539.58 |
| Total Drug Medicare PaymentAmount | 1998.1 |
| Total Drug Medicare Standardized Payment Amount | 1998.1 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 81 |
| Number Of Medical Services | 6296 |
| Number Of Medicare Beneficiaries With Medical Services | 1413 |
| Total Medical Submitted Charge Amount | 429377 |
| Total Medical Medicare Allowed Amount | 287793.23 |
| Total Medical Medicare Payment Amount | 201870.02 |
| Total Medical Medicare Standardized Payment Amount | 212216.22 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 210 |
| Number Of Beneficiaries Age 65 to 74 | 447 |
| Number Of Beneficiaries Age 75 to 84 | 477 |
| Number Of Beneficiaries Age Greater 84 | 279 |
| Number Of Female Beneficiaries | 744 |
| Number Of Male Beneficiaries | 669 |
| Number Of Non Hispanic White Beneficiaries | 1352 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 0 |
| Number Of Hispanic Beneficiaries | 34 |
| Number Of American Indian Alaska Native Beneficiaries | 12 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1109 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 304 |
| Percent Of With Atrial Fibrillation | 21 |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 31 |
| Percent Of With Chronic Kidney Disease | 29 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 33 |
| Percent Of With Depression | 29 |
| Percent Of With Diabetes | 38 |
| Percent Of With Hyperlipidemia | 71 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 43 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 48 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.4507 |